A Comparison of the Volume and pH of Gastric Contents of Obese and Lean Surgical Patients
| Autor: | Matthew G. Kramer, William B. Kelly, Cara E. Perez, Roger Dzwonczyk, Ronald L. Harter |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Sedation Population Pneumonia Aspiration Body Mass Index Medicine Humans Obesity Gastrointestinal Contents education Aged education.field_of_study Gastric Acidity Determination business.industry Stomach Surgical procedures Middle Aged Surgery medicine.anatomical_structure Anesthesiology and Pain Medicine Surgical Procedures Operative Female medicine.symptom business Body mass index Surgical patients |
| Zdroj: | Survey of Anesthesiology. 42:363 |
| ISSN: | 0039-6206 |
| DOI: | 10.1097/00132586-199812000-00060 |
| Popis: | Obese surgical patients are typically considered to be more likely than lean patients to possess high-volume and low-pH (HVLP) gastric contents after a standard preoperative fast, based on a study of a population predominately consisting of patients receiving intramuscular preoperative sedation. We revisited this issue in a study population of 256 fasted surgical patients, of which 232 received no preoperative antacid or gastric prokinetic drug. Immediately after endotracheal intubation, an 18-French sump tube was placed, and gastric contents were withdrawn. Subjects' gastric contents were defined as HVLP if they exhibited a combination of a volume25 mL and a pH2.5. Obesity was defined as a body mass index30. Among nonmedicated obese patients, the proportion with HVLP gastric contents was 20 of 75 (26.6%). The proportion of lean patients with HVLP gastric contents was 66 of 157 (42.0%). The difference between the HVLP proportions for these two groups was found to be significant (P0.05) using chi 2 analysis. Obesity seems to be associated with a significantly decreased risk of HVLP gastric contents among surgical patients with no history of gastroesophageal pathology after a normal interval of preoperative fasting.Previous studies have shown that obese surgical patients have a greater volume of acidic stomach contents than lean patients, despite a routine preoperative fast. We have reexamined this issue and found that among otherwise healthy, fasted, obese surgical patients, there is a lower incidence of combined high-volume, low-pH stomach contents compared with lean patients. |
| Databáze: | OpenAIRE |
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